BARTELLA, Iraq (AP) " A boy and a woman are delivered to the gates of the clinic by an Iraqi ambulance, bandaged and in pain. They arrive without names, ages and with only the sketchiest details of what had happened to them.
Apparently shot by accident outside their house in western Mosul, where fighting continues between Iraqi forces and Islamic State group militants, U.S. medics working in a state-of-the-art field clinic here could only assume they were mother and son.
Situated on the outskirts of Mosul, the facility was set up last December by Samaritan's Purse, a Christian aid organization based in Boone, North Carolina. Its volunteer doctors receive those with the gravest injuries from the field clinics inside or at the very edge of Mosul, where casualties are initially treated.
"At home, it's not nearly as critical as this," said Medical Services Director Shelly Kelly, from Mustang, Oklahoma.
Kelly, who is on her second assignment in Iraq, said it took some effort to explain to her family why her new place of work was located behind blast walls. In the end they gave her their support, however.
"My parents actually watch my kids and wash my laundry when I'm not there, and make meals for my husband, so it's all good," said the mother of four.
Kelly completed several overseas assignments for Samaritan's Purse before coming to this war-torn Middle Eastern nation. U.S. staff typically come for rotations of four to eight weeks, often using their vacation time to serve.
"It's really an easy choice," said Kelly, saying the rewards are much bigger than what a beach vacation could bring.
Adrian Curnow, a pediatric surgeon from Boise, Idaho, just started his assignment " his first foreign mission " three days ago. He said he was surprised at the severity of the injuries he was encountering.
Preparing to operate on the wounded boy, he faced an issue common to all underage patients: Where are the parents and who will give consent to the operation? In the confusion of war, the answers are not easily found.
Curnow managed to speak to the woman and she told him, just before slipping into unconsciousness, that she was not, in fact, the boy's mother. Following U.S. procedure, he decided to go ahead after consulting a colleague and the patients were moved into the operating room.
Both patients had already been operated on at the field clinic they were sent from. The boy's abdomen needed only to be cleaned but the female patient was in a much worse state. A bullet had severed her spine and also damaged her kidney.
Clinic doctors first decided to remove the organ but, checking on the other side, saw that she had no second kidney: It had either been taken out overnight at the field clinic or perhaps removed before in an unrelated operation. The team worked to save what was left of the remaining kidney.
The woman survived the operation.
Names, family details, medical history, all essential part of the workflow back home, are often obscured in the fog of war, but field medics have learned to work around these things.
Both operations lasted more than two hours, leaving the staff exhausted. Kelly grabbed a moment to eat and to reflect. Working abroad had changed her forever, she said, as it had all her colleagues. With several such missions behind her, she said coming home was often not easy.
"I think it was anger, pushing my family away, and just trying to process through what I have seen here," she said of her last return home. It took time and understanding from the family to get back into the rhythm of everyday life.
"Finally I told my husband I think a month after I had been home, there was a day when I told him, I feel normal," she said.